From the Guidelines
Hashimoto's thyroiditis typically presents with signs and symptoms such as fatigue, weight gain, hair loss, cold intolerance, constipation, depression, and other recognized symptoms, which can be suspected based on lab tests showing high TSH and low free T4 levels, as well as the presence of thyroid antibodies like thyroid peroxidase (TPO) antibody 1. The condition often progresses slowly, with symptoms appearing gradually over months or years as thyroid function declines. Some key points to consider include:
- Common signs and symptoms: fatigue, increased sensitivity to cold, constipation, dry skin, unexplained weight gain, puffy face, hoarseness, muscle weakness, elevated cholesterol levels, muscle aches and stiffness, joint pain, irregular or heavy menstrual periods, depression, and impaired memory.
- Initial hyperthyroid phase: some patients may experience anxiety, rapid heartbeat, and weight loss before developing hypothyroid symptoms.
- Physical examination: may reveal an enlarged thyroid (goiter) that feels rubbery and firm.
- Blood tests: typically show elevated thyroid-stimulating hormone (TSH), low thyroid hormones (T3 and T4), and the presence of thyroid peroxidase antibodies (TPOAb) or thyroglobulin antibodies (TgAb).
- Autoimmune process: the immune system mistakenly attacks the thyroid gland, causing inflammation and gradual destruction of thyroid tissue. It is essential to consult a healthcare provider for proper testing and diagnosis if these symptoms are experienced. Additionally, the USPSTF recommends screening for thyroid dysfunction in asymptomatic populations, with the serum TSH test being the primary screening test 1. However, the optimal screening interval for thyroid dysfunction is unknown, and more research is needed to determine the benefits and harms of screening and treatment for thyroid dysfunction. In summary, Hashimoto's thyroiditis is a condition that requires proper testing and diagnosis, and patients should be aware of the signs and symptoms to seek medical attention if necessary 1.
From the Research
Signs and Symptoms of Hashimoto's Thyroiditis (Hypothyroidism)
The signs and symptoms of Hashimoto's thyroiditis (hypothyroidism) include:
- Fatigue
- Weight gain
- Increased sensitivity to cold (cold intolerance)
- Irregular bowel movements (constipation)
- Dry skin (xeroderma) 2, 3, 4 These conditions are mostly the result of a low metabolic rate in the body, with weight gain occurring due to a decrease in fat-burning rate and cold intolerance due to a decrease in heat production by the body 2.
Clinical Presentation
The symptoms of hypothyroidism can go unnoticed, may not be specific, and may overlap with other conditions, which makes it harder to diagnose it in some cases 2. The classic symptoms of hypothyroidism include fatigue, lethargy, weight gain, and cold intolerance; however, these symptoms are non-specific and the diagnosis is typically made on biochemical grounds through serum thyroid function tests 4.
Diagnosis and Treatment
The diagnosis of hypothyroidism is based on laboratory tests that measure the levels of thyroid hormones (T3 and T4) in the blood 2. Treatment typically involves lifelong hormone replacement therapy with synthetic thyroid hormone replacement medication, such as levothyroxine, to help regulate hormone levels in the body 2, 3, 4. Levothyroxine monotherapy is the standard treatment for hypothyroidism; it is safe and inexpensive, restores thyroid function tests to within the reference range, and improves symptoms in the majority of patients 4.
Management and Prevention
Lifestyle modifications like eating healthy food and exercising regularly can help manage the symptoms and improve the quality of life 2. Vitamin D supplementation has shown promise in reducing antithyroid antibody levels, improving thyroid function, and improving other markers of autoimmunity 5. An anti-inflammatory diet rich in vitamins and minerals and low in animal foods has been suggested to have a protective effect 6.